Hora da admiss？o na unidade de emergência e mortalidade hospitalar na síndrome coronária aguda

background: the relationship between admission time to an emergency service and in-hospital outcomes in acute coronary syndrome (acs) is controversial. admission during off-hours would be associated with worse prognosis. objective: to assess the influence of admission time on prolonged hospitalization and mortality for acs patients, regarding regular hours (7am-7pm) and off-hours (7pm-7am). methods: the study assessed prospectively 1,104 consecutive acs patients. in-hospital mortality and length of hospital stay > 5 days were the outcomes analyzed. results: admission during regular hours was greater as compared with that during off-hours (63% vs. 37%; p < 0.001). unstable angina was more prevalent during regular hours (43% vs. 32%; p < 0.001), while non-st-segment elevation myocardial infarction (nstemi) was during off-hours (33% vs. 43%; p = 0.001). differences in neither mortality nor length of hospital stay were observed in the time periods studied. predictive factors for length of hospital stay > 5 days were as follows: age [or 1.042 (95%ci: 1.025 - 1.058), p < 0.001]; ejection fraction (ef) [or 0.977 (95%ci: 0.966 - 0.988), p < 0.001]; nstemi [or 1.699 (95%ci: 1.221 - 2.366), p = 0.001]; and smoking [or 1.723 (95%ci: 1.113 - 2.668), p = 0.014]. predictive factors for in-hospital mortality were as follows: age [or 1.090 (95%ci: 1.047 - 1.134), p < 0.001]; ef [or 0.936 (95%ci: 0.909 - 0.964), p < 0.001]; and surgical treatment [or 3.781 (95%ci: 1.374 - 10.409), p = 0.01]. conclusion: prolonged length of hospital stay and in-hospital mortality in acs patients do not depend on admission time.